Implant Fixture is Mobile: Best Course of Treatment?

Screw it out, clean the site, dont need to graft if the defect is 5 or 4 walled. Wait for 10 weeks, do a scan, plan properly and insert a new one, not necessarily wider. Anyway, 6 month is way to long for D2.

It is lost remove and can place larger but due to the amount of time and possible bone issues best to leave. I always graft now though to prevent bone dimension loss in re-modelling . I always use a Bacteriostatic graft material that can set hard and is then fully bio-abroebed and you can then replace an implant at 3 to 4 months dependant on patient physiology. Many cases with great results.

Take a good look at the case to try to determine why the implant failed. If you cannot determine this, it is possible that you can get another failure in your second attempt. Remove the implant, and all the granulomatous or fibrous tissue lining the area from the apex to the gingival border to obtain a clean surface of bone. If there is not enough bleeding from the bone, obtain a good bleeding bone surface as the source of bone producing cells and vasculature that will inducethe best biological conditions for the graft to first be infiltrated by blood vessels that will support the replacement of the graft with viable bone. You don't have to attempt primary closure, just cover the graft with a resorbable collage membrane that will last 3 or 4 months and wait. Reenter in 4 months to place a second implant, (not wider, the 4 mm implant is just about the right size for that tooth) and wait for osseointegration before uncovering. May take a little longer than usual if you are used to a one stage procedure, but you want to be extra safe. Make sure your drilling speed or technique is not heating the bone. Good luck!

To Peter Fairbairn Could you please give details (name, manufacturer etc.)of the bacteriostatic graft material that you mentioned in your a/m post?? Thanks Danny Reshef